title: Abdominal surgical site infections: a prospective study of determinant factors in Harare, Zimbabwe.
abstract: Surgical site infections (SSIs) are reported in lower frequencies in the developed countries than in the developing world. A prospective evaluation of risk factors in 285 patients undergoing abdominal surgery procedures in Zimbabwe was therefore undertaken. Overall infection rate was 26%. The age group 30-39 years had the highest number of dirty wounds and the highest rate of human immunodeficiency virus (HIV) infection. Multivariate regression analysis showed a correlation between wound class and SSI (P < 0·05). This was also noted for American Society of Anesthesiologists (ASA) score (P < 0·05). HIV-infected patients had 52% SSIs and non-infected patients had 26% (P < 0·05). Patients receiving blood transfusion had 51% SSIs and those not transfused had 17% (P < 0·01). Patients receiving pre- and intra-operative prophylactic antibiotics had 18% SSIs and those receiving postoperative administration had 37% (P < 0·01). Treatment ranged from dressings only in 11% to surgical intervention in 30% resulting in prolongation of median hospital stay from 8 to 18 days (P < 0·001). Mortality was 7%. High wound class, high ASA score, blood transfusion, HIV infection and delayed use of prophylactic antibiotics were risk factors for SSIs, resulting in surgical interventions, prolonged hospital stay and mortality.
authors.affiliation: Department of Surgery, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: David
authors.initials: D
authors.lastname: Muchuweti
authors.affiliation: Department of Surgery, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
authors.forename: Kent U G
authors.initials: KU
authors.lastname: Jönsson
mesh_terms: D000005:Abdomen / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001803:Blood Transfusion; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology*; D055815:Young Adult; D015030:Zimbabwe
chemical_list: D000900:Anti-Bacterial Agents
keywords: Blood transfusion; HIV infection; Prophylactic antibiotics; Surgical site infection; Wound class